A new Cochrane Systematic Review looking at whether it is better to target a lower or higher level of oxygen for babies born very early has rated “the quality of the evidence as high for the key outcomes of death, major disability, the composite of death or major disability, and necrotising enterocolitis.” The quality of evidence was rated as “moderate for the two eye-related outcomes (blindness, retinopathy of prematurity requiring treatment), giving confidence that the overall results are reliable.”
The author’s of the study conclude that in extremely preterm infants, targeting lower (85% to 89%) SpO₂ compared to higher (91% to 95%) SpO₂ had no significant effect on the composite outcome of death or major disability or on major disability alone, including blindness, but increased the average risk of mortality by 28 per 1000 infants treated. The trade-offs between the benefits and harms of the different oxygen saturation target ranges may need to be assessed within local settings (e.g. alarm limit settings, staffing, baseline outcome risks) when deciding on oxygen saturation targeting policies.
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